Subjects -> HEALTH AND SAFETY (Total: 1508 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (704 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (385 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (123 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (704 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 2)
Acta Informatica Medica     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 27)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 2)
African Health Sciences     Open Access   (Followers: 4)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 43)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 6)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 18)
American Journal of Health Education     Hybrid Journal   (Followers: 34)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 10)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 29)
American Journal of Public Health     Full-text available via subscription   (Followers: 264)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 6)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 12)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 14)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 4)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 4)
Archives of Suicide Research     Hybrid Journal   (Followers: 7)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 10)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 5)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 12)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 12)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 49)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 12)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 23)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 23)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 1)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 4)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 5)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 15)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 23)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 22)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 8)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 2)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 4)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 14)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 17)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Frontiers of Health Services Management     Partially Free   (Followers: 3)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access   (Followers: 1)
Global Health Promotion     Hybrid Journal   (Followers: 17)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 8)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 17)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 13)
Health and Human Rights     Open Access   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 69)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 16)
Health Equity     Open Access  
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 23)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  

        1 2 3 4 | Last

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Frontiers in Public Health
Number of Followers: 8  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2296-2565
Published by Frontiers Media Homepage  [85 journals]
  • Epidemiological Investigation and Etiological Analysis of a Cutaneous
           Anthrax Epidemic Caused by Butchering Sick Cattle in Guizhou, China

    • Authors: Shijun Li, Qing Ma, Hong Chen, Ying Liu, Guanghai Yao, Guangpeng Tang, Dingming Wang
      Abstract: A suspected human cutaneous anthrax epidemic caused by butchering sick cattle occurred in Zhijin County of Guizhou Province, Southwest of China, in 2016. Epidemiological investigation and etiological analysis were performed to provide a scientific basis for the source tracking of the epidemic. The epidemic was epidemiologically investigated, and skin blister samples collected from patients and soil samples collected from the butchering spots were used for Bacillus anthracis isolation. The suspicious B. anthracis isolates were identified using conventional methods and PCR, followed by genotyping using multiple-locus variable-number tandem repeats (VNTRs) analysis (MLVA-15) and canonical single-nucleotide polymorphism (canSNP). The genetic relationship of epidemic strains and isolates collected from other regions was analyzed. Epidemiological investigation results showed that the patients may be infected by B. anthracis during butchering sick cattle. Two suspected B. anthracis strains were isolated from blood samples and blister fluids, respectively. Conventional methods identified the two suspected isolates as B. anthracis, while PCR results showed that anti-protective antigen (PA) and capsule (CAP) gene were positive in the two isolates. MLVA-15 showed that the MLVA profiles of the two isolates were 9-20-12-53-16-2-8-8-8-4-4-4-4-10-4, which is different from the MLVA profiles of representative strains from other regions. CanSNP analysis showed that the two strains belonged to cluster A.Br.001/002. Clustering analysis and minimum spanning tree (MST) demonstrated that the two isolates were clustered with strains previously isolated from Guizhou Province. The results indicated that B. anthracis was the pathogen for this epidemic, and the patients were infected during butchering the sick. The genetic characteristics and the relationship of the B. anthracis isolates to strains from other regions indicated that the epidemic was a local occurrence.
      PubDate: 2020-03-25T00:00:00Z
       
  • Association Between Socioeconomic and Demographic Characteristics and
           Non-fatal Alcohol-Related Injury in Maringá, Brazil

    • Authors: Deena El-Gabri, Nicole Toomey, Nelly Moraes Gil, Aline Chotte de Oliveira, Paulo Rafael Sanches Calvo, Yolande Pokam Tchuisseu, Sarah Williams, Luciano Andrade, Joao Ricardo Nickenig Vissoci, Catherine Staton
      Abstract: Background: Previous research has corroborated a high burden of alcohol-related injury in Brazil and the presence of socioeconomic disparities among the injured. Yet, individual-level data is scarce. To fill this gap, we examined the association between demographic and socioeconomic characteristics with non-fatal alcohol-related injury in Maringá, Brazil.Methods: We used household survey data collected during a 2015 cross-sectional study. We conducted univariate and multivariate analyses to evaluate associations of demographic (age, gender, race) and socioeconomic characteristics (employment, education, income) with non-fatal alcohol-related injury.Results: Of the 995 participants who reported injuries, 62 (6.26%) were alcohol-related. Fifty-three (85%) alcohol-related injuries were reported by males. Multivariate analysis indicated being male (OR = 5.98 95% CI = 3.02, 13.28), 15–29 years of age (OR = 3.62 95% CI = 1.72, 7.71), and identifying as Black (OR = 2.38 95% CI = 1.09, 4.95) were all significantly associated with increased likelihood of reporting an alcohol-related injury, whereas unemployment was significantly associated with decreased likelihood of reporting an alcohol-related injury (OR = 0.41 95% CI = 0.18, 0.88).Conclusion: Our findings suggest that in Maringá, being male, between the ages of 15 and 29, employed, or identifying as Black were characteristics associated with a higher risk for non-fatal alcohol-related injury. Individual level data, such as ours, should be considered in combination with area-level and country-level data when developing evidence-based public-health policies.
      PubDate: 2020-03-25T00:00:00Z
       
  • Occupational Health Inequalities by Issues on Gender and Social Class in
           Labor Market: Absenteeism and Presenteeism Across 26 OECD Countries

    • Authors: Min Jung Kwon
      Abstract: Background: This study aimed to examine the health disparities among working populations of 26 OECD countries through absenteeism and presenteeism, and to explain the combined effects of gender, work-life imbalance, occupational class, and labor market gender inequality factors on the occurrence of them.Methods: We investigated nested data on 30,131 wage workers across 26 OECD countries. At the country level, macro indicators representing labor market gender inequality were collected from OECD database. Multi-level logistic analysis was used to analyze the main and interacting effects of explanatory variables on absenteeism and presenteeism.Results: This study revealed a negative relationship between gender inequalities in the labor market and the incidence of absenteeism and presenteeism. After controlling for relevant individual- and country-level factors, the gender wage gap was associated with a decrease in absenteeism and presenteeism but the gender gap in the employment rate had a similar effect only on presenteeism. In addition, these country-level factors worked differently for the risk of absenteeism and presenteeism among groups of workers by gender, level of work-life imbalance, employment condition, and occupational class.Conclusion: Workers in societies with separate gender roles and structural inequalities in the labor market reported lower levels of absenteeism and presenteeism, which was explained by an association between the double burden of work and family life and occupational health. In other respects, however, gender egalitarian policies may play an essential role in preventing health disadvantages for unfavorable working groups of women, non-permanent contract and manual job.
      PubDate: 2020-03-25T00:00:00Z
       
  • Prevalence of Antibiotic Resistome in Ready-to-Eat Salad

    • Authors: Shu-Yi-Dan Zhou, Meng-Yun Wei, Madeline Giles, Roy Neilson, Fei Zheng, Qi Zhang, Yong-Guan Zhu, Xiao-Ru Yang
      Abstract: Ready-to-eat salad harbors microorganisms that may carry various antibiotic resistance genes (ARGs). However, few studies have focused on the prevalence of ARGs on salad, thus underestimating the risk of ARGs transferring from salad to consumers. In this small-scale study, high-throughput quantitative PCR was used to explore the presence, prevalence and abundance of ARGs associated with serving salad sourced from two restaurant types, fast-food chain and independent casual dining. A total of 156 unique ARGs and nine mobile genetic elements (MGEs) were detected on the salad items assessed. The abundance of ARGs and MGEs were significantly higher in independent casual dining than fast-food chain restaurants. Absolute copies of ARGs in salad were 1.34 × 107 to 2.71 × 108 and 1.90 × 108 to 4.87 × 108 copies per g salad in fast-food and casual dining restaurants, respectively. Proteobacteria, Bacteroidetes, Actinobacteria, and Firmicutes were the dominant bacterial phyla detected from salad samples. Pseudomonas, Acinetobacter, Exiguobacterium, Weissella, Enterobacter, Leuconostoc, Pantoea, Serratia, Erwinia, and Ewingella were the 10 most dominant bacterial genera found in salad samples. A significant positive correlation between ARGs and MGEs was detected. These results integrate knowledge about the ARGs in ready-to-eat salad and highlight the potential impact of ARGs transfer to consumers.
      PubDate: 2020-03-25T00:00:00Z
       
  • Battle Against Musculoskeletal Tumors: Descriptive Data of Military
           Hospital Experience

    • Authors: Cagri Neyisci, Yusuf Erdem
      Abstract: Background: Management of musculoskeletal tumors remains challenging for orthopedic surgeons. The aim of this cross-sectional study was to present the prevalence and localization of musculoskeletal disorders diagnosed and treated at a tertiary referral military hospital.Method: A total of 552 patients' medical records who presented to our clinic between 2009 and 2014 with the diagnosis of musculoskeletal tumors were retrospectively analyzed according to age, gender, bone/soft tissue localization, histopathological diagnosis, incidence, and treatment.Results: Of the cases diagnosed with tumor, 225 were soft tissue localized, 317 bone localized, and 10 tumor-like lesions. The most common primary benign soft tissue tumors were lipoma, ganglion, and giant cell tumor of tendon sheath, while the most common malignant soft tissue tumors were liposarcoma and synovial sarcoma, respectively. The most common primary bone tumors were osteochondroma, enchondroma, and simple bone cyst, while the most common malignant bone tumors were osteosarcoma, Ewing sarcoma and chondrosarcoma, respectively. Myositis ossificans was found as the most common tumor-like lesion.Conclusion: Descriptive data in musculoskeletal tumors is crucial in terms of improving treatment and reducing mortality. In this study, no significant difference was found between the data of tertiary military hospital regarding epidemiology of musculoskeletal system tumors and those from the literatures around Turkey.
      PubDate: 2020-03-25T00:00:00Z
       
  • The Impact of Occupational Stress on Job Burnout Among Bank Employees in
           Pakistan, With Psychological Capital as a Mediator

    • Authors: Arslan Khalid, Fang Pan, Ping Li, Wei Wang, Abdul Sattar Ghaffari
      Abstract: Background: Job burnout is a major issue for workers in the banking sector. Many employees report feeling exhausted and want to leave their jobs due to the extra pressure and workload from their superiors and clients. They also report not being well compensated for their hard work, which they believe they do to provide the best service to their clients.Methods: A cross-sectional study was made in various banks in different cities of Pakistan. An adapted questionnaire, including the effort-reward imbalance scale, psychological capital, and Maslach burnout inventory general survey were used to collect data from 1,778 male and female bank employees.Results: There was a significant and positive relationship between extrinsic effort and over-commitment on the one hand, and emotional exhaustion and depersonalization on the other. It was also found that reward was negatively associated with emotional exhaustion and depersonalization. However, reward had a positive association with personal accomplishment. There was a gender difference in the mediating effect of psychological capital on stress at work and job burnout.Conclusion: Male attitudes to work tend to be motivated by reward and appreciation, whereas females tend to demand a better working environment. To reduce job, burnout suitable interventions could be introduced for bank employees, whilst management support plays an important role in increasing or decreasing stress in employees.
      PubDate: 2020-03-24T00:00:00Z
       
  • AQVx—An Interactive Visual Display System for Air Pollution and
           Public Health

    • Authors: Grant J. Williamson, Christopher Lucani
      Abstract: Fine particulate matter emissions (PM2.5) from landscape biomass fires, both prescribed and wild, pose a significant public health risk, with smoke exposure seasonally impacting human populations through both highly concentrated local plumes, and more dispersed regional haze. A range of technologies now exist for mapping and modeling atmospheric particulate concentration, including low-cost mobile monitors, dispersion and chemical transport modeling, multi-spectral earth observation satellites, weather radar, as well as publicly available real-time data feeds from agencies providing information about fire activity on the ground. Ubiquitous smart phone availability also allows instant public reporting of both health symptoms and smoke exposure. We describe a web-based visual display interface, Air Quality Visualization (AQVx), developed to allow the overlaying, synchronization and comparison of a range of maps and data layers, in order to both assess the potential public health impact of landscape fire smoke plumes, and the accuracy of dispersion models. The system was trialed in the state of Victoria, in south-eastern Australia, within the domain of the AQFx chemical transport model, where large-scale annual prescribed burning operations (~11,000 km2 yr) are carried out, and where extreme wildfires frequently occur during the summer months. AQVx, coupled with the ARSmoke smart phone application, allowed managers to rapidly validate modeled smoke transport against satellite imagery, and identify potential exposure risks to populated areas.
      PubDate: 2020-03-24T00:00:00Z
       
  • Identification of High-Risk Pregnancies in a Remote Setting Using
           Ambulatory Blood Pressure: The MINDI Cohort

    • Authors: Doris González-Fernández, Emérita del Carmen Pons, Delfina Rueda, Odalis Teresa Sinisterra, Enrique Murillo, Marilyn E. Scott, Kristine G. Koski
      Abstract: Background: Ambulatory blood pressure is a potential tool for early detection of complications during pregnancy, but its utility in impoverished settings has not been assessed. This cross-sectional study aimed to determine whether maternal infections, nutrient deficiencies and inflammation (MINDI) were associated with four measures of maternal blood pressure (BP) and to determine their association with symphysis-fundal-height (SFH).Methods: Environmental and dietary factors, intake of iron and a multiple-nutrient supplement (MNS), markers of inflammation, protein, anemia, folate, vitamins B12, A and D status, and urogenital, skin, oral and intestinal nematode infections were measured in indigenous pregnant Panamanian women. Stepwise multiple linear and logistic regression models explored determinants of systolic and diastolic blood pressure (SBP, DBP), hypotension (SBP < 100 and DBP < 60), mean arterial pressure (MAP), elevated MAP (eMAP), and pulse pressure (PP). Associations of BP with intestinal nematodes and with SFH Z scores (≥16 wk) were also explored.Results: Despite absence of high SBP or DBP, 11.2% of women had eMAP. Furthermore, 24.1% had hypotension. Linear regression showed that hookworm infection was associated with higher SBP (P = 0.049), DBP (P = 0.046), and MAP (P = 0.016), whereas Ascaris was associated with lower DBP (P = 0.018) and MAP (P = 0.028). Trichomonas was also associated with lower SBP (P < 0.0001) and MAP (P = 0.009). The presence of Trichuris (OR: 6.7, 95% CI 1.0–44.5) and folic acid deficiency (OR: 6.9, 95% CI 1.4–33.8) were associated with increased odds of eMAP. The odds of low BP was higher in the presence of Ascaris (OR: 3.63 ± 2.28, P = 0.040), but odds were lowered by MNS (OR: 0.35 ± 0.11, P = 0.001), more intake of animal-source foods/wk (OR: 0.7, 95% CI 0.5–0.9) and by higher concentrations of IL-17 (OR: 0.87 ± 0.05, P = 0.016).Conclusion: MINDI were bi-directionally associated with blood pressure indicators. In this MINDI cohort, infections, nutrients and cytokines both raised, and lowered BP indices. The presence of eMAP identified pregnant women at risk of hypertension whereas low PP was associated with lower SFH. Therefore, MAP and PP may help in detecting women at risk of adverse pregnancy outcomes in settings with limited access to technology.
      PubDate: 2020-03-24T00:00:00Z
       
  • Determinants of Inappropriate Antibiotics Use in Rural Central Ghana Using
           a Mixed Methods Approach

    • Authors: Samuel Afari-Asiedu, Felix Boakye Oppong, Alma Tostmann, Martha Ali Abdulai, Ellen Boamah-Kaali, Stephaney Gyaase, Oscar Agyei, John Kinsman, Marlies Hulscher, Heiman F. L. Wertheim, Kwaku Poku Asante
      Abstract: Background: The consequences of antibiotic resistance are projected to be most severe in low and middle income countries with high infectious disease burden. This study examined determinants of inappropriate antibiotic use at the community level in rural Ghana.Methods: An observational study involving qualitative and quantitative methods was conducted between July, 2016 and September, 2018 in Ghana. Two household surveys were conducted at two time points (2017 and 2018) among 1,100 randomly selected households over 1 year. The surveys focused on antibiotic use episodes in the past month. Four in-depth interviews and two focus group discussions were performed to further explain the survey results. Determinants of inappropriate antibiotic use were assessed using a mixed effect logistic regression analysis (multilevel analysis) to account for the clustered nature of data. We defined inappropriate antibiotic use as either use without prescription, not completing treatment course or non-adherence to instruction for use. Qualitative data were thematically analyzed.Results: A total of 1,100 households was enrolled in which antibiotics were used in 585 (53.2%) households in the month prior to the surveys. A total of 676 (21.2%) participants out of 3,193 members from the 585 reportedly used antibiotics for 761 episodes of illness. Out of the 761 antibiotic use episodes, 659 (86.6%) were used inappropriately. Paying for healthcare without health insurance (Odds Ratio (OR): 2.10, 95% CI: 1.1–7.4, p-value: 0.026), not seeking healthcare from health centers (OR: 2.4, 95% CI: 1.2–5.0, p-value: 0.018), or pharmacies (OR: 4.6, 95% CI: 1.7–13.0, p-value: 0.003) were significantly associated with inappropriate antibiotic use. Socio-demographic characteristics were not significantly associated with inappropriate antibiotic use. However, the qualitative study described the influence of cost of medicines on inappropriate antibiotic use. It also revealed that antibiotic users with low socioeconomic status purchased antibiotics in installments which, could facilitate inappropriate use.Conclusion: Inappropriate antibiotic use was high and influenced by out-of-pocket payment for healthcare, seeking healthcare outside health centers, pharmacies, and buying antibiotics in installments due to cost. To improve appropriate antibiotic use, there is the need for ministry of health and healthcare agencies in Ghana to enhance healthcare access and healthcare insurance, and to provide affordable antibiotics.
      PubDate: 2020-03-24T00:00:00Z
       
  • Ability to Monitor National Responses to the HIV Epidemic “Beyond Viral
           Suppression”: Findings From Six European Countries

    • Authors: Kelly Safreed-Harmon, Meaghan Kall, Jane Anderson, Natasha Azzopardi-Muscat, Georg M. N. Behrens, Antonella d'Arminio Monforte, Udi Davidovich, Teymur Noori, Jeffrey V. Lazarus
      Abstract: Objective: With more people living with HIV (PLHIV) ageing into their 50s and beyond in settings where antiretroviral therapy is widely available, non-AIDS comorbidities and health-related quality of life (HRQoL) are becoming major challenges. Information is needed about whether national HIV monitoring programmes have evolved to reflect the changing focus of HIV care.Methods: We created a 56-item English-language survey to assess whether health systems report on common health-related issues for people with HIV including physical and mental health comorbidities, HRQoL, psychosocial needs, and fertility desires. One expert was identified via purposive sampling in each of six countries (Estonia, Italy, the Netherlands, Slovenia, Sweden, and Turkey) and was asked to participate in the survey.Results: Three respondents reported that the current monitoring systems in their countries do not monitor any of four specified aspects of 10 comorbidities including bone loss, cardiovascular disease, and neurocognitive disorders. Two respondents stated that their countries potentially can report on leading causes of hospital admission among PLHIV, and five on leading cases of death. In three countries, respondents reported that there was the ability to report on the HRQoL of PLHIV. In two countries, respondents provided data on the percentage of PLHIV denied health services because of HIV status in the past 12 months.Conclusions: This study identified areas for potential HIV monitoring improvements in six European countries in relation to comorbidities, HRQoL, discrimination within health systems, and other issues associated with the changing nature of the HIV epidemic. It also indicated that some countries either currently monitor or have the ability to monitor some of these issues. There are opportunities for health information systems in European countries to expand the scope of their HIV monitoring in order to support decision-making about how the long-term health-related needs of PLHIV can best be met.
      PubDate: 2020-03-20T00:00:00Z
       
  • The Association of Body Fat Percentage With Hypertension in a Chinese
           Rural Population: The Henan Rural Cohort Study

    • Authors: Ruiying Li, Zhongyan Tian, Yanhua Wang, Xiaotian Liu, Runqi Tu, Yan Wang, Xiaokang Dong, Yikang Wang, Dandan Wei, Huiling Tian, Zhenxing Mao, Linlin Li, Wenqian Huo, Chongjian Wang, Ronghai Bie
      Abstract: Background: Obesity is an important risk factor for hypertension. Previous studies have explored the association between body fat percentage (BFP) and hypertension, but evidence on the consistency of the association remains uncertain and limited. The aim of this study was to explore the relationship between BFP and hypertension in a Chinese rural population.Methods: The present cross-sectional study including 38,913 eligible individuals was conducted in rural areas of Henan province. BFP was measured by bioelectrical impedance methods using Omron body fat and weight measurement device. Logistic regression models and restricted cubic spline regression models were performed to investigate the relationship between BFP and hypertension. Receiver operating characteristic (ROC) analyses were used to compare the discriminating power of adiposity indices.Results: The age-standard prevalence of hypertension was 23.74 and 17.87% in males and females, respectively. Compared with the first quartile of BFP, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension in the highest BFP quartile were 3.30 (95% CI: 2.85, 3.83) in males and 2.66 (95% CI: 2.36, 2.99) in females, and the adjusted ORs increased along with increasing BFP levels. The areas under ROC and 95% CIs of BFP were 0.673 (0.665, 0.682) in males and 0.696 (0.689, 0.703) in females, respectively.Conclusions: BFP was significantly positively associated with the prevalence of hypertension in both males and females in the Chinese rural population. Controlling of body fat should be emphasized in rural areas of China.Clinical Trial Registration: Registration number: ChiCTR-OOC-15006699. http://www.chictr.org.cn/showproj.aspx'proj=11375
      PubDate: 2020-03-20T00:00:00Z
       
  • Community-University Partnership Characteristics for Translation: Evidence
           From CDC's Prevention Research Centers

    • Authors: Belinda-Rose Young, Kimberly D. Leeks, Connie L. Bish, Paul Mihas, Rose A. Marcelin, Jennifer Kline, Brigette F. Ulin
      Abstract: Background: The Centers for Disease Control and Prevention's Prevention Research Centers (PRC) Program supports community engagement and partnerships to translate health evidence into practice. Translation is dependent on the quality of partnerships. However, questions remain about the necessary characteristics to develop and maintain translation partnerships.Aim: To identify the characteristics that influence community-university partnerships and examine alignment with the Knowledge to Action (K2A) Framework.Methods: Final Progress Reports (N = 37) from PRCs funded from September 2009 to September 2014 were reviewed in 2016–2017 to determine eligibility. Eligible PRCs included those that translated an innovation following the applied research phase (2009–2014) of the PRC award (n = 12). The PRCs and the adopters (i.e., community organizations) were recruited and participated in qualitative interviews in 2017.Results: Ten PRCs (83.3% response rate) and four adopters participated. Twelve codes (i.e., elements) were found that impacted partnerships along the translation continuum (e.g., adequate communication, technical assistance). Each element aligned with the K2A Framework at multiple steps within the translation phase. The intersection between the element and step in the translation phase is termed a “characteristic.” Using interview data, fifty-two unique partnership characteristics for translation were found.Discussion and Conclusion: The results suggest multiple characteristics that impact translation partnerships. The inclusion of these partnership characteristics in policies and practices that seek to move practice-based or research-based evidence into widespread use may impact the receptivity by partners and evidence uptake by communities. Using the K2A Framework to assess translation partnerships was helpful and could be considered in process evaluations to inform translation partnership improvement.
      PubDate: 2020-03-20T00:00:00Z
       
  • Influenza A Virus Infection in Cats and Dogs: A Literature Review in the
           Light of the “One Health” Concept

    • Authors: Stéphanie Borland, Patrice Gracieux, Matthew Jones, François Mallet, Javier Yugueros-Marcos
      Abstract: Influenza A viruses are amongst the most challenging viruses that threaten both human and animal health. Constantly evolving and crossing species barrier, the emergence of novel zoonotic pathogens is one of the greatest challenges to global health security. During the last decade, considerable attention has been paid to influenza virus infections in dogs, as two canine H3N8 and H3N2 subtypes caused several outbreaks through the United States and Southern Asia, becoming endemic. Cats, even though less documented in the literature, still appear to be susceptible to many avian influenza infections. While influenza epidemics pose a threat to canine and feline health, the risks to humans are largely unknown. Here, we review most recent knowledge of the epidemiology of influenza A viruses in dogs and cats, existing evidences for the abilities of these species to host, sustain intraspecific transmission, and generate novel flu A lineages through genomic reassortment. Such enhanced understanding suggests a need to reinforce surveillance of the role played by companion animals-human interface, in light of the “One Health” concept and the potential emergence of novel zoonotic viruses.
      PubDate: 2020-03-20T00:00:00Z
       
  • The Effect of Mechanical Massage and Mental Training on Heart Rate
           Variability and Cortisol in Swedish Employees—A Randomized Explorative
           Pilot Study

    • Authors: Willeke Van Dijk, Anja C. Huizink, Jasmin Müller, Kerstin Uvnäs-Moberg, Anette Ekström-Bergström, Linda Handlin
      Abstract: Work-related stress is relatively common in modern society and is a major cause of sick-leave. Thus, effective stress reducing interventions are needed. This study examined the effects of mental training and mechanical massage, on employee's heart rate variability (HRV) and plasma cortisol at their workplaces. Moreover, it was investigated whether baseline systolic blood pressure (SBP) can explain differences in effectiveness of the intervention. Ninety-three participants from four workplaces were randomly assigned to one of the five programs: (I) Mechanical massage and mental training combined, II) Mechanical massage, III) Mental training, IV) Pause, or V) Control. HRV and plasma cortisol were measured at baseline and after 4 and 8 weeks. SBP was measured at baseline. On the reduction of cortisol levels, a small effect of the mechanical massage program was found, whereas no effect was found for the other programs. None of the programs showed any effect on HRV. Nonetheless, when the level of systolic blood pressure was taken into account, some small beneficial effects on HRV and cortisol of mental training and the mechanical massage were found. This exploratory pilot-study provides useful information for future studies that aim to reduce stress among employees.
      PubDate: 2020-03-19T00:00:00Z
       
  • Nature's Contributions to Human Health: A Missing Link to Primary Health
           Care' A Scoping Review of International Overview Reports and
           Scientific Evidence

    • Authors: Laura Lauwers, Hilde Bastiaens, Roy Remmen, Hans Keune
      Abstract: Nature's contributions to human health (NCH) have gained increased attention internationally in scientific and policy arenas. However, little attention is given to the role of the health care sector in this discussion. Primary health care (PHC) is a vital backbone for linking knowledge and practice within the organization of health care. The objective of this scoping review is to evaluate how international overview reports and scientific literature on NCH address to PHC. More specifically, we extracted data on arguments, practice supporting tools and guidelines, challenges and constraints, and management approaches to integrate NCH and PHC. The scientific literature search was run in Web of Science. Two independent reviewers screened the scientific publications. Through the scientific literature search, we identified 1,995 articles of which 79 were eligible for analysis. We complemented the search with a selection of six international overview reports. Both the international overview reports and the scientific publications paid limited attention to the role of PHC regarding NCH. To cope with the current challenges and constraints to integrate NCH and PHC, more evidence on NCH, further development of PHC practice supporting tools, bottom–up integrated approaches, and closer interdisciplinary collaborations are required.
      PubDate: 2020-03-18T00:00:00Z
       
  • Increasing the Offer, Shifting the Offer: Patients' Perspectives on
           Routinely Offering HIV Counseling and POC Testing in the Health Services
           Program of an Urban Community Health Centre

    • Authors: Lynne Elizabeth Leonard, Sarah Vannice, Lindsay Wilson, Celia McCellan, Candis Lepage
      Abstract: Objectives: Canadian epidemiologic data demonstrate the fallibility of established HIV testing approaches to reach, diagnose, and link to care a significant portion of the population thereby contributing to missed opportunities to reduce onward HIV transmission. Increasing and diversifying entry points to accessing HIV testing may be a successful strategy to reach people who remain undiagnosed. We sought to determine the perspectives of patients on the acceptability of an offer of routine non-targeted provider-initiated HIV counseling and point-of-care (POC) testing in the health services program of a Community Health Centre in downtown Ottawa, the capital of Canada.Methods: Patients aged 18 years and over accessing the Health Services Program for scheduled clinical appointments were approached by research staff with the offer of a POC HIV test with pre- and post-test counseling. All patients accepting the offer and those declining the offer were offered the opportunity to complete an Acceptability Questionnaire.Results: Questionnaire responses from eligible patients over four consecutive weeks in 2018 strongly endorse the acceptability of an offer of an HIV test in the context of their scheduled health services appointment for a separate clinical condition. This contention held both for those patients accepting the offer and proceeding to testing and for those patients declining the offer.Conclusions: The perspectives of the patients in our study demonstrate that a routine offer of non-targeted provider-initiated HIV counseling and POC testing was considered not only to be an acceptable, but also an appropriate and welcome intervention in a community health services program. These results suggest the potential for actively engaging more individuals—including those less likely to be engaged through a targeted testing approach—in the documented benefits of the HIV care and treatment cascade by increasing the HIV test offer through routine provider initiation. In addition, at the population level, shifting the offer through venue diversification, similarly shows potential for reducing engagement in ongoing HIV transmission behaviors and practices attributed to those unaware of their HIV positive status. Both outcomes fundamental to the goal of eliminating AIDS by 2030.
      PubDate: 2020-03-18T00:00:00Z
       
  • Gastrointestinal Carriage of Vancomycin-Resistant Enterococci and
           Carbapenem-Resistant Gram-Negative Bacteria in an Endemic Setting:
           Prevalence, Risk Factors, and Outcomes

    • Authors: Alexandra Vasilakopoulou, Polyxeni Karakosta, Sophia Vourli, Aikaterini Tarpatzi, Paraskevi Varda, Maria Kostoula, Anastasia Antoniadou, Spyros Pournaras
      Abstract: Background: Gastrointestinal carriage of vancomycin-resistant enterococci (VRE) and carbapenem-resistant Gram-negative bacteria (CRGN) constitutes a major public health concern as it may be followed by clinical infection development or lead to intra-hospital dissemination. Detection of carriers and implementation of infection control measures are essential in every hospital. In this study we determined the point prevalence of VRE and CRGN in the fecal flora of the inpatients of a tertiary university hospital in Greece. We determined risk factors for carriage and examined the impact of carriage on hospital outcomes.Materials/Methods: A point prevalence study of VRE/CRGN rectal carriage of inpatients was conducted on March 2018. Specimens were selectively cultured for VRE/CRGN, microorganisms were biochemically identified, submitted to antibiotic susceptibility testing, and tested for carbapenemase production. Data on potential risk factors and hospital outcomes were collected at the time of culture and until hospital discharge. Multivariable logistic and linear regression models were used, adjusting for confounders.Results: Four hundred ninety-one patients were enrolled in the study. Of them, 64 (13.0%) were positive for VRE carriage, 40 (8.2%) for CRGN, and 10 patients (2.1%) for both VRE and CRGN. VRE carriage was independently associated with age over 65 years (adjusted OR: 2.4 [95%CI: 1.3, 4.5]) and length of stay (LOS) before rectal sampling (OR: 1.1 [95%CI: 1.0, 1.1]). Carriage of CRGN was associated with 11 days increase of LOS after rectal sampling (β-coef: 11.4 [95%CI: 1.6, 21.2]), with a 3.5-fold increased risk of acquiring a resistant pathogen after rectal swabbing (RR: 3.5 [95%CI 1.2, 9.9]) and with a 6-fold increased risk of mortality (RR: 6.1 [95%CI: 2.1, 17.9]), after adjusting for sex, age, and comorbidity index.Conclusions: High prevalence rates were found for VRE and CRGN carriage among the inpatients of our hospital. Prolonged hospitalization and age were independent risk factors for VRE carriage, while CRGN carriage was associated with increased risk of acquiring a resistant pathogen, prolonged hospital stay, and increased mortality.
      PubDate: 2020-03-18T00:00:00Z
       
  • WOmen's Action for Mums and Bubs (WOMB) Trial Protocol: A Non-randomized
           Stepped Wedge Implementation Trial of Participatory Women's Groups to
           Improve the Health of Aboriginal and Torres Strait Islander Mothers and
           Children in Australia

    • Authors: Karen Carlisle, Catrina Felton-Busch, Yvonne Cadet-James, Judy Taylor, Ross Bailie, Jane Farmer, Megan Passey, Veronica Matthews, Emily Callander, Rebecca Evans, Janet Kelly, Robyn Preston, Michelle Redman-MacLaren, Haylee Fox, Adrian Esterman, Merrick Zwarenstein, Sarah Larkins
      Abstract: Introduction: In Australia, there have been improvements in Aboriginal and Torres Strait Islander maternal health, however inequities remain. There is increasing international evidence illustrating the effectiveness of Participatory Women's Groups (PWGs) in improving Maternal and Child Health (MCH) outcomes. Using a non-randomized, cluster stepped-wedge implementation of a complex intervention with mixed methods evaluation, this study aims to test the effectiveness of PWGs in improving MCH within Indigenous primary care settings in Australia and how they operate in various contexts.Methods: This study takes place in ten primary health care services across Australia and involves the recruitment of existing PWGs or the setting up of new PWGs. Services are paired based on geography for practical reasons and two services commence the PWG intervention at three monthly intervals, with the initial four services being those with existing women's groups. Implementation of the PWGs as an intervention involves training local facilitators of PWG groups, supported engagement with local MCH data through workshops, PWGs identifying and prioritizing issues and strengths and co-implementing solutions with health services. Outcomes are measured with yearly MCH audits, a cost-effectiveness study, and process evaluation of community participation and empowerment.Discussion: This study is the first to formally implement and quantitatively, yet with contextual awareness, measure the effect of applying a community participation intervention to improve the quality of Aboriginal and Torres Strait Islander MCH in Australia. Findings from this work, including detailed theory-producing qualitative analysis, will produce new knowledge of how to facilitate improved quality of MCH care in Indigenous PHC settings and how to best engage community in driving health care improvements.Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618000945224.Web address: http://www.ANZCTR.org.au/ACTRN12618000945224.aspx
      PubDate: 2020-03-18T00:00:00Z
       
  • Clustering and Tracking the Stability of Biological CVD Risk Factors in
           Adolescents: The Malaysian Health and Adolescents Longitudinal Research
           Team Study (MyHeARTs)

    • Authors: Nithiah Thangiah, Karuthan Chinna, Tin Tin Su, Muhammad Yazid Jalaludin, Nabilla Al-Sadat, Hazreen Abdul Majid
      Abstract: Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time.Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages.Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13–15 year) to 19.5% (15–17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%.Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.
      PubDate: 2020-03-17T00:00:00Z
       
  • CD19+CD1dhiCD5hi B Cells Can Downregulate Malaria ITV Protection by IL-10
           Secretion

    • Authors: Hongli Guan, Jiacong Peng, Liping Jiang, Gang Mo, Xiang Li, Xiaohong Peng
      Abstract: Infection treatment vaccine (ITV) can lead to sterile protection against malaria infection in mice and humans. However, parasite breakthrough is frequently observed post-challenge. The mechanism of rapid decline in protection after the last immunization is unclear. Herein, C57BL/6 mice were immunized with 103, 105, or 107 ITV thice at 14-day intervals. Mice were challenged with 103 parasites at 1, 3, and 6 months after last immunization and the protection was checked using blood smear. The phenotypes of B cells were analyzed by flow cytometry. The levels of serum cytokines were quantified using cytometric bead array. The 103 ITV vaccination group exhibited 100% protection at 1 month after last immunization, and the 105 group showed sterile protection at 3 months after last immunization. However, the 107 group showed only partial protection. Further, the protection declined to 16.7% at 6 months after last immunization in 105 and 107 groups, whereas it maintained for more than 60% in 103 group. The number of memory B cells (MBC) decreased along with the decline in protection. However, programmed cell death protein 1 (PD-1) expressed on MBCs did not show significant variation among the three groups. Interestingly, CD19+CD1dhiCD5hi B cells, defined as B10 cells, exhibited negative regulation with respect to protection. The numbers of CD19+CD1dhiCD5hi B cells in the 103 group at 1 months and in the 105 group at 3 months post-immunization were the lowest compared to those in the other groups. Moreover, the serum levels of interleukin 10 (IL-10) in these two groups were also significantly lower than those in other groups. We conclude that higher immunization dose may not lead to better protection with the malaria vaccine as CD19+CD1dhiCD5hi B cells can downregulate ITV protection against malaria via IL-10 secretion. These results could facilitate the design of an effective long-lasting malaria vaccine with the aim of maintaining MBC function.
      PubDate: 2020-03-17T00:00:00Z
       
 
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